New DHS rule would make it harder for immigrants and others to receive care

October 24, 2018

Blue Shield of California, Care 1st Health Plan and Blue Shield of California Foundation urge the Trump administration to halt a potential change in policy that would make it harder for immigrants and others to seek health and well-being services.

“The proposed rule goes against our mission to ensure that all Californians have access to high-quality health care at an affordable price, and threatens the overall well-being of our communities,” said Gary Cohen, vice president of government affairs, Blue Shield. “No one living in California should be denied the health care they need because they can’t afford it or be afraid to receive services they are entitled to because it might affect their ability to enter or stay in the country.”

About the proposed rule

On Oct. 10, the Department of Homeland Security (DHS) issued a proposed rule – Inadmissibility on Public Charge Grounds – that changes how the department determines if an individual is eligible to enter the United States or to receive a green card.

Federal immigration laws allow the United States to deny entry or a green card to an individual who may become a “public charge” – an individual who is primarily dependent on the government for support.

Under current policy, the public benefits that are considered in a public charge determination are cash benefits or institutionalized long-term care. The proposed rule expands this list of public benefits to include Medi-Cal, Medicare Part D Low Income Subsidy Program, food stamps and housing assistance. The proposed rule does not include the Healthy Families Program (although the proposed rule asks for comments on including this program) and subsidies for the health exchanges.

“Our mission is to improve the lives of all Californians and we believe that can only happen when people can access services and programs that support good health and well-being,” said Peter Long, president and CEO, Blue Shield of California Foundation. “The proposed rule from the Trump administration is creating fear and distress among families who are forgoing essential services because of the potential immigration repercussions. These decisions have long-term impacts on children and families that could ultimately limit their opportunities to succeed.”

A September Kaiser Family Foundation report, co-funded by Blue Shield of California Foundation, found that current immigration policy has already negatively impacted the finances, health and well-being of immigrant families:

Families have growing fears about participating in health, nutrition, and other programs

Families were scared that accessing services could jeopardize the chances of having their detained or deported family member released or allowed to return to the U.S. They also feared it could prevent themselves from obtaining legal status or citizenship in the future and/or put others at risk for deportation. As such, many were not participating in food assistance or other programs, including the Supplemental Nutrition Assistance Program (SNAP) and Free or Reduced Price Lunch, even though they were having problems affording food and their U.S.-born children would likely qualify. Stakeholders also reported declines in public program participation as well as use of other services. They noted that potential changes to public charge policies are escalating fears, even among legal permanent residents and citizens.

The public has 60 days, until Dec. 10, to comment on the proposed rule. DHS will consider the public comments, then publish a final rule.